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J Thorac Cardiovasc Surg 2007;134:373-377
© 2007 The American Association for Thoracic Surgery

General Thoracic Surgery

Sleeve and wedge parenchyma-sparing bronchial resections in low-grade neoplasms of the bronchial airway

Marco Lucchi, MDa,*, Franca Melfi, MDa, Alessandro Ribechini, MDb, Paolo Dini, MDa, Leonardo Duranti, MDa, Gabriella Fontanini, MDc, Alfredo Mussi, MDa

a Division of Thoracic Surgery, University of Pisa, Pisa, Italy
b Service of Thoracic Endoscopy, University of Pisa, Pisa, Italy
c Cardiac and Thoracic Department, and the Division of Pathology, University of Pisa, Pisa, Italy.

Received for publication January 31, 2007; revisions received February 19, 2007; accepted for publication March 16, 2007.

* Address for reprints: M. Lucchi, MD, Division of Thoracic Surgery, Cardiac and Thoracic Department, University of Pisa, Via Paradisa 2, Pisa 56124, Italy. (Email: m.lucchi{at}med.unipi.it).

Objective: Sleeve and wedge bronchial resections without parenchymal resection may represent a surgical option in selected cases of low-grade neoplasms of the airway. We reviewed our experience analyzing the indications, the operative technique, and the results of such operations.

Methods: From 1980 to 2006, we performed 248 bronchoplastic procedures, and 26 of those were bronchoplastic procedures without parenchymal resection for low-grade neoplasms of the airway. There were 17 men and 9 women with a mean age of 49.4 years (range 19-74 years). All patients underwent a preoperative bronchoscopic study, which gave indication for such a procedure, and an intraoperative bronchoscopic examination confirming the feasibility and the good quality of the bronchial suture. The bronchial resection involved the trachea and the carina (n = 5), the main bronchi (n = 7), the intermediate bronchus (n = 2), the bronchial corner (n = 6), and the lobar bronchus (n = 6).

Results: The resection margins were always tumor free. There was no operative mortality. The mean hospital stay was 6.7 days (range 4–16 days). One minimal dehiscence and no stenosis of the anastomosis were observed. In 1 case we experienced a granulation that required an endoscopic treatment. The histologic type was carcinoid (n = 18), mucoepidermoid (n = 2), adenoid cystic (n = 1), chondroma (n = 2), hamartoma (n = 1), melanoma endobronchial metastasis (n = 1), and glomic tumor (n = 1). The mean follow-up was 134 months and no local relapse occurred.

Conclusion: Bronchoplastic procedures without resection of the lung parenchyma are a suitable and fascinating technique for selected cases of low-grade endobronchial neoplasms.

Abbreviations and Acronyms CT = computed tomography






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